The present invention relates to the field of protein misfolding diseases and thus to diseases which are associated with or induced by abnormal or pathogenic three-dimensional folding of proteins and/or peptides or which are linked to pathogenic conformational changes of proteins and/or peptides. Especially, the present invention refers to neurodegenerative diseases which are related to or caused by protein misfolding like Alzheimer's disease and the like.
Especially, the present invention refers to novel specific trimeric pyrazole compounds which exhibit a therapeutic effectiveness in regard to the aforementioned protein misfolding diseases, especially in so far as they are able to suppress or at least to reduce the misfolding of proteins and/or the aggregation of misfolded proteins to layered aggregates, like amyloid plaques. Furthermore, the specific trimeric pyrazole compounds according to the present invention are additionally capable to disassemble already existing misfolded proteins and/or aggregates of misfolded proteins.
The present invention also relates to novel specific trimeric pyrazole compounds for the prophylactic and/or therapeutic (i.e. curative) treatment of protein misfolding diseases, especially neurodegenerative diseases.
Furthermore, the present invention refers to the use of at least one trimeric pyrazole compound of the invention for the prophylactic and/or therapeutic (i.e. curative) treatment of protein misfolding diseases, especially neurodegenerative diseases.
Further, the present invention relates to the use of trimeric pyrazole compounds of the invention for producing a medicament or a pharmaceutical for the prophylactic and/or therapeutic (i.e. curative) treatment of protein misfolding diseases, especially neurodegenerative diseases.
In addition, the present invention also refers to a medicament and/or pharmaceutic composition comprising at least one trimeric pyrazole compound of the invention for the prophylactic and/or therapeutic (i.e. curative) treatment of protein misfolding diseases, especially neurodegenerative diseases.
Moreover, the present invention also provides a kit for the inventive uses and treatment methods as described herein, the kit comprising at least one trimeric pyrazole compound of the invention, preferably in a suitable application form.
Furthermore, the present invention also refers to a method of treatment of protein misfolding diseases, especially neurodegenerative diseases, wherein at least one trimeric pyrazole compound is used and preferably applied to a human or animal suffering from a protein misfolding disease, especially a neurodegenerative disease.
Finally, the present invention also refers to methods for synthesizing (producing) and/or for the providing of the specific trimeric pyrazole compounds of the invention.
In physiology, one of the most important processes can be seen in the folding of the translated linear strand of amino acids into a fully functional three-dimensional protein, which represents one of the most complex challenges facing the cellular protein factory. A large amount of physiological tools reveal a tightly regulated assembly line and multiple factors guide nascent proteins to select the correct shape and/or conformation from an almost infinite array of possibilities. Furthermore, in biological systems, specific control mechanisms exist which ensure that misfolded products are targeted for degradation before they cause harm. However, a failure or malfunction of these control systems or the excessive occurrence of protein misfolding, also especially after protein biosynthesis (i.e. the conversion of normally folded protein into pathogenic forms) can result in a huge variety of diseases, which are commonly designated as protein misfolding diseases or diseases related to protein misfolding.
Among the protein misfolding diseases, Alzheimer's disease, Bovine Spongiforme Encephalopathy (BSE), Creutzfeldt-Jacob's disease (CJD), Huntington's disease, Lewy Body dementia, Parkinson's disease, Diabetes mellitus of type II and Alzheimer's disease (AD) can be mentioned exemplarily.
With respect to Creutzfeldt-Jacob's disease or CJD, which is the most common among the types of transmissible spongiforme encephalopathies found in humans, this protein misfolding disease is caused by prions and is thus sometimes also designated as a prion disease. The prion that is believed to cause CJD exhibits at least two stable conformations. The native state is water-soluble and present in healthy cells. Its biological function is presumably in transmembrane transport or signaling. The other confirmation state is very poorly water-soluble and readily forms protein aggregates. The CJD prion is dangerous because it promotes refolding of native proteins into the diseased state resulting in β-pleated sheets. The number of misfolded protein molecules thus increases exponentially and the process leads to a large quantity of insoluble prions in affected cells. This mass of misfolded proteins disrupts cell function and causes cell death. The misfolding is characterized by a folding of the dominantly α-helica regions into β-pleated sheets of the CJD prion. There is currently no cure for CJD. The disease is invariably fatal.
Diabetes mellitus type II also represents a protein misfolding disease. With respect to this disease, the so-called amyloid polypeptide (IAPP or amylin) is commonly found in pancreatic islets of patients suffering from Diabetes mellitus type II or harbouring an insulinoma. Recent results suggest that IAPP can induce apoptotic cell-death in insulin-producing β-cells. IAPP is capable of forming amyloid fibrils in vitro. Within the fibrillization reaction, the earlier prefibrillar structures are extremely toxic to β-cell and insuline producing cells. A later amyloid fiber structures also seems to have some cytotoxic effect on cell cultures. Therefore, IAPP represents an important pharmacological target for the treatment of Diabetes mellitus II diseases.
Moreover, also Alzheimer's disease has been identified as a protein misfolding disease (proteopathy), caused by accumulation of abnormally folded A-β and tau-proteins in the brain.
Furthermore, so-called synuclein also represents an interesting pharmacological target. The protein α-synuclein has been found to be mutated in several families with autosomal dominant Parkinson's disease. Mutations in α-synuclein are associated with early-onset of especially familiar Parkinson's disease. The protein aggregates abnormally in Parkinson's disease, Alzheimer's disease, Lewy body disease and other neurodegenerative diseases.
Thus, previously unrelated diseases, such as Alzheimer's disease, prion diseases and diabetes, share the pathological feature of aggregated misfolded proteins, which especially occur in the form of large deposits in biological systems (e.g. amyloid plaques in Alzheimer's disease). This common principle suggests that these protein misfolding diseases are linked by common principles, which therefore represents common targets for therapeutic intervention and approaches.
Not at least due to the high impact on the persons concerned, neurodegenerative diseases play an important role among the aforenamed protein misfolding diseases. In general, neurodegenerative diseases can be defined as a condition in which cells of the brain and/or spinal cord are lost, resulting in a decrease of essential functions of the brain, especially with regard to the cognitive and/or motoric function as well as the processing of sensory information. In this context, neurodegenerative diseases are commonly linked with conditions affecting memory and related to dementia but also with conditions causing problems of the control of movements, such as ataxia. Neurodegeneration is often caused by misfolding of proteins, especially in such a way that the misfolded proteins can no longer perform their regular cellular functions and instead trigger equivalent modifications in normal proteins, thus creating a cascade of damage that eventually results in significant neuronal death. Normally, neurodegeneration begins long before the patient experiences any symptoms. It can be months or years before any effect is felt. In general, symptoms are noticed when many cells die or cease to function.
The most common form of dementia is the so-called Alzheimer's disease (AD), which is synonymously also denoted as Alzheimer disease, Senile Dementia of the Alzheimer Type (SDAT) or simply Alzheimer's. Generally, it is diagnosed in people over 65 years of age, although the less-prevalent early-onset of AD can occur much earlier. As of September 2009, this number is reported to be at least 35 million worldwide. The prevalence of AD is estimated to reach approximately 107 million people by 2050.
Although the cause of AD is unique for every individual, there are many common symptoms. The earliest observable symptoms are often mistakenly thought to be age-related concerns or manifestations of stress. In the early stages, the most commonly recognized symptom is memory loss, such as difficulty in remembering recently learned facts. As the disease advances, symptoms include confusion, irritability and aggression, mood swings, language breakdown, long-term memory loss and the general withdrawal of the sufferer as the senses of the person concerned decline. Regularly, body functions are lost, ultimately leading to death. AD develops for an indeterminate period of time before coming fully apparent and it can progress undiagnosed for years. The mean life expectancy following diagnosis is approximately seven years. Fewer than three percent of individuals live more than fourteen years after diagnoses.
Alzheimer's disease is characterized by loss of neurons and synopsis in the cerebral cortex and certain subcortical regions. This loss results in gross atrophy of the affected regions of the brain, including degeneration in the temporal lobe and parietal lobe, and parts of the frontal cortex and cingulat gyrus.
Alzheimer's represents a protein misfolding disease caused by accumulation of abnormally folded A-β and tau-proteins in the brain. Plaques are made up of small peptides, 39 to 43 amino acids in length, called beta-amyloid (also written as A-β or Aβ or ABeta). Beta-amyloid is a fragment from a larger protein called amyloid precurser protein (APP), a transmembrane protein that penetrates through the neuron's membrane. APP is critical to neuron growth, survival and postinjury repair. In Alzheimer's disease, APP is divided into smaller fragments by enzymes through proteolysis. One of these fragments gives rise to fibrils of beta-amyloid, which forms clumps that are deposited outside of neurons in dense formations known as senile plaques or amyloid plaques.
Amyloid beta (A-β, Aβ or ABeta) is a peptide of 39 to 43 amino acids that appears to be the main constituent of amyloid plaques in the brains of persons suffering from protein misfolding diseases, like Alzheimer's disease. Similar plaques appear in some variants of Lewy body dementia. The plaques formed by Aβ are composed of a tangle of regularly ordered fibrillar aggregates called amyloid fibers, a protein fold which is also shared by other peptides such as prions associated with other protein misfolding diseases, like CJD. Aβ is formed after sequential cleavage of the amyloid precursor protein, a transmembrane glycoprotein. Aβ protein is generated by successive action of the so-called β- and γ-secretases. The γ-secretase, which produces the C-terminal end of the Aβ-peptide, cleaves within the transmembrane region of APP and can generate a number of isoforms of 39 to 43 amino acid residues in length. The most common isoforms are Aβ40 and Aβ42. The shorter Aβ40 form is the more common one, wherein Aβ42 represents the more fibrillogenic isoform of Aβ. Thus, Aβ42 is the most amyloidogenic form of the peptide.
The accumulation of beta-amyloid peptides is discussed as the central event triggering neuron degeneration. Accumulation of aggregated amyloid fibrils, which are believed to be the toxic form of the protein and seem to be responsible for disrupting the cell calcium ion homeostasis, induces programmed cell death (apoptosis). It is also known that Aβ selectively builds up in the mitochondria in the cells of Alzheimer's-affected brains and that it also inhibits certain enzyme functions and the utilization of glucose by neurons.
Alzheimer's disease is also considered as a tauopathy due to abnormal aggregation of the so-called tau-protein. The tau-protein stabilizes the microtubules as a part of the cytoskeleton in the phosphorylated form thereof. Therefore, it is called a microtubule-associated protein. In AD, the tau-protein undergoes chemical changes and becomes hyperphosphorylated. It then begins to pair with other thread, creating neuro-fibrillary tangles and disintegrating the neuron's transport system.
Furthermore, the degeneration of the muscarinergic cholinerg neurons in AD is associated with a chronic deficiency of the neurotransmitter acetylcholine (ACh), resulting in a significantly decreased signal transmission between the affected neurons.
Up to now, there is no cure for Alzheimer's disease. Available treatments offer relatively small symptomatic benefit but remain palliative in nature. Current treatments can be divided into pharmaceutical, psychosocial and caregiving. Four medications are currently approved by regulatory agencies to treat the cognitive manifestations of AD. Three of them can be classified as acetylcholine esterase inhibitors and the remaining one is an NMDA receptor antagonist. However, no drug has an indication for delaying or halting the progression of the disease.
Thus, on the whole, Alzheimer's disease (AD) is a steadily increasing threat, especially for industrialized countries with a growing percentage of old individuals. Research on potential therapies has been going on for several decades now, without producing one single drug which is able to cure Alzheimer's disease. Since AD is accompanied by many diverse symptoms, numerous avenues have been exploited in the search of a therapy. Antiinflammatory, antihypertensive as well as hypolipidemic agents, passive and active immunisation, cholinergic therapies, neuroprotective agents, glutamate receptor antagonists, β- and γ-secretase inhibitors, β-amyloid and tau aggregation inhibitors, metal chelating agents, monoamine oxidase inhibitors, medicinal plants are only a number of the most prominent classes. In recent years passive immunization with Aβ-specific antibodies held most promise for a breakthrough, however, the results of phase II clinical trial revealed only moderate or weak effects with a large percentage of treated patients. As a consequence, the call for small molecules was revived and reinitiated.
A plethora of small molecules has been screened in the past three decades for their antiaggregation potential against the Alzheimer's peptide. Among these, often colored heterocyclic compounds have been identified, which are in general thought to somehow intercalate between the insoluble cross-β-sheet structure of Aβ fibrils (e.g. congo red, rifampicin, melatonin, cucurmin) Zn- and Cu-chelating agents were thought to lower the aggregation tendency of monomeric Aβ strands (clioquinol). Another prevailing class of compounds are peptides, in some cases taken directly from putative nucleation sites within the Aβ molecule, however, only very few of these compounds stem from rational design with a known structural motif in their complexes with Aβ-monomers, oligomers or fibrils. In this context, a β-sheet breaker LPFFD (iAbeta5) retained the high affinity towards the self-complementary KLVFF region of Aβ, but impaired its β-sheet forming propensity by introducing a proline-kink; the D-peptide LVFFV (PPI-1019) essentially interferes with the aggregation of β-amyloid in the brain and may help to promote its clearance. Furthermore, in prior art, hybrid peptides built from KLVFF and a highly charged KKKKK or EEEEE terminus have been synthesized. Aggregation of toxic Aβ oligomers is promoted because of an increased surface tension.
Another prominent class are alternating N-methylated and non-methylated peptide amides or esters. These are able to cap growing β-sheets without the ability of crosslinking because their back is blocked for hydrogen bonding due to the sterically demanding N-methyl groups or ester oxygens. These substances have recently been optimized with respect to the antiaggregatory capacity by introduction of three cyclohexylglycine units and reached nanomolar IC50 values. The compound is also thought to accelerate Aβ self-assembly and thereby deplete the level of neurotoxic Aβ-oligomers. Other examples comprise the small molecule homotaurin, which disrupts complexes between Aβ and glucosaminoglycans. Scyllo-inositol appears to bind oligomers of Aβ42, preventing them from damaging synapses. Oligomer-specific Aβ antibodies indicated that scyllo-inositol appears to increase the number of monomers and trimers while reducing the amount of larger oligomeric species, such as 40 mers. A recent approach focuses on Aβ binders from D-peptide libraries by phage display methods.
However, little knowledge and information is available on the exact mechanism of action for most Aβ complexing agents, even less on structural details. Furthermore, the effectiveness of the substances is not always sufficient and there are also questions arising with regard to the physiological compatibility of the substances.
Furthermore, a promising approach with regard to the treatment of AD base on the use of aminopyrazoles, which have proven to bind selectively to the backbone of misfolded peptides residing in the β-sheet confirmation.
In prior art, several aminopyrazoles were synthesized with additional side chains for enhanced water solubility. A combination of two consecutive proteinogenic amino acids, flanked by external aminopyrazolecarboxylate was shown to be complementary to an extended β-sheet. Such derivatives were synthesized and also evaluated on the solid phase. Direct interaction of dimeric and trimeric aminopyrazole derivatives with the mouse prion protein as well as with Aβ(1-42) was shown and characterized by SDS-PAGE (Sodium Dodecyl Sulphate Polyacrylamide Gel Electrophoresis), FCS (Fluorescence Correlation Spectroscopy), AUC (Analytical Ultra Centrifugation), density gradient centrifugation as well as HRMS (High Resolution Mass Spectrometry). The β-sheet recognition as well as the individual strength of all hydrogen bonds involved were also studied in prior art by R2PI spectroscopy on a cooled argon jet stream. It is also known that a trimeric aminopyrazole carboxylate trimer is capable to disassemble preformed Aβ-fibrils in a dose- and time-dependant manner. However, all the aforementioned substances only exhibit a moderate effect with regard to the target structure and are neither optimized with respect to an improved effectiveness in view of an improved compatibility and availability at the pharmacological site of action.
WO 03/095429 A1 refers to substances having a donor-acceptor/donor-structure on the basis of heterocyclic compounds being linked to specific residues. The donor/acceptor/donor-pattern corresponds to the β-pleated sheet structure of a misfolded protein. The substances described in this document prevent in some respects the aggregation of misfolded proteins into β-amyloid plaques.
Furthermore, WO 2007/112922 A1 relates to trimeric water-soluble aminopyrazole compounds having a radical at the N-terminal site of the molecule in the form of a straight-chain or branched alkyl group or an amino acid group or a polyamino acid group and having a specific radical at the C-terminal site of the molecule in the form of a NOH, OR3 or NHR3 group, in which R3 is a straight chain or a branched alkyl group or an amino acid group or a polyamino acid group. The molecules described in this document also have a certain effect on the Aβ-protein.
Although the respective substances named in the above documents have a certain effect on Aβ-protein, there still remains a great need and potential for a further improvement of the effectiveness of substances especially interacting with misfolded proteins, like the Aβ-protein. Furthermore, there also still remains a need to improve the bioavailability of these substances, especially at the place and/or site of pharmacological action, in particular taking into consideration the penetration of the blood/brain-barrier.
Thus, especially in view of the seriousness of protein misfolding diseases like Alzheimer's disease and the high incidence of these diseases, there is an urgent need for providing new therapeutic approaches and new therapeutic compounds being effective with respect to the treatment of protein misfolding diseases like Alzheimer's disease.